POEMS Syndrome

Treatment

Treatment for POEMS syndrome depends on the stage and severity of the disorder. The choice of treatment must be made with care, balancing the risks and benefits of each type. A multidisciplinary team of physicians at Mayo Clinic combine their skills to develop a treatment plan for each patient.

Treatment for POEMS syndrome may include radiation therapy, corticosteroids, chemotherapy, a bone marrow transplant, hormone replacement therapy and physical therapy. All patients need lifelong follow-up for this condition because relapses are possible.

Radiation Therapy

If diagnostic results reveal minimal development of the plasma cell clone (osteosclerotic myeloma) the doctor may recommend radiation therapy. Radiation therapy uses high-energy X-rays, electron beams or radioactive isotopes to kill the plasma cell clone. Radiation oncologists tailor each treatment to protect nearby normal tissue. At Mayo Clinic, patients have access to the most advanced systems for treatment planning and delivery.

Corticosteroids

These powerful anti-inflammatory agents subdue the body's immune response. Physicians at Mayo Clinic may prescribe prednisone or another corticosteroid. Occasionally, corticosteroid creams are applied directly to the skin.

Chemotherapy

When abnormal plasma cells are widespread, hematologists or oncologists may administer chemotherapy. Chemotherapy uses drugs to destroy the abnormal plasma cells. A hematologist or medical oncologist will administer chemotherapy orally or through the patient's veins.

Bone Marrow Transplant

Mayo Clinic is a leader in exploring the use of bone marrow transplant to treat patients who have POEMS. Early results (see research publications) show that BMT treatment improves some symptoms for the majority of patients. However there are some significant side effects, and how long the improvements will persist is not yet known.

Hormone Replacement

If there are hormonal abnormalities, endocrinologists will help to develop a customized hormone replacement plan. Physicians at Mayo Clinic will discuss the pros and cons of hormone replacement therapy with each patient. Hormone replacement therapy has been shown to relieve some symptoms of POEMS syndrome.

Physical Therapy

Physical therapy is highly recommended if there has been significant disability caused by neuropathy (weakening of feet, legs, hands and arms). Physical therapists at Mayo Clinic develop treatment exercise programs to increase mobility.

Treating Nerve Damage

Patients with POEMS suffer many symptoms. The worst symptoms are usually caused by nerve damage. Patients can develop extreme, progressive weakness (neuropathy) of their extremities (feet, legs, hands and arms). The most effective method to stop the progression or advancement of this weakness is to kill the plasma cell clone (the osteosclerotic myeloma). Research shows that as the osteosclerotic myeloma is treated, many other symptoms will improve, including skin changes, swelling of the extremities and enlarged organs. The hormonal abnormalities may or may not improve. The nerve problem may or may not improve, depending on how advanced the disease is by the time treatment begins.